Effect of glycemic control on periodontal parameters in people with type 2 diabetes – a single-arm interventional pilot trial

Background & Aim Periodontitis and type 2 diabetes (T2D) show a bidirectional relationship. This pilot study investigated how glycemic control affected periodontal status in people with T2D.

Methods Patients with inadequately T2D (baseline HbA1c-value≥8.0) and periodontitis were scheduled to receive both intensification of antihyperglycaemic therapy and periodontal examinations, without further prophylaxis or subgingival instrumentation during a 3-month study period. Clinical assessments at baseline (T1) and 3 months (T2) included metabolic assessment (HbA1c), pocket probing depth (PPD), bleeding on probing (BOP), periodontal inflamed surface area (PISA), plaque index (PI), and gingival index (GI). Primary outcome parameter was PISA.

Results The successful reduction in HbA1c in 17 out of 20 patients (from in average 9.3 to 8.2%) after 3.8±1.1 month resulted additionally in significant reductions of PISA, BOP and PI (p=0.0014; p=0.0008; p=0.048). Furthermore, at T2 significant associations between HbA1c and oral clinical parameters were found when adjusting for age, BMI and treatment time. Higher HbA1c values lead to reduced oral health, which is reflected in increased values of PISA (p=0.006), BOP (p=0.026) and tooth mobility (p=0.015).

Conclusions This study provides evidence that glycemic control can significantly improve periodontal inflammation over a short period of 3-months independent of periodontal therapy without extended periodontal therapy. These findings underline the importance of a good glycemic control for periodontal health in people with T2D.

Publication History

Article published online:
28 May 2025